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Giardiasis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Noninvasive diarrhea

  • Found worldwide:

    • 2–15% prevalence in developed nations

    • 20–40% prevalence in developing nations

  • 5% of all travelers’ diarrhea

  • Most common intestinal parasite in US:

    • Hig...

Diagnosis

Signs and Symptoms

History

  • Onset 1–2 wk postexposure

  • Infection may be asymptomatic (most common).

  • Diarrhea of acute onset (90% of symptomatic patients):

    • Foul-smelling stools

    • Steatorrhea

    • Nonbloody

    • Se...

Treatment

Initial Stabilization/Therapy

  • ABCs: Airway, breathing, circulation

  • IV 0.9% NS if signs of significant dehydration

  • For severe dehydration (>10%):

    • IV bolus with 0.9% NS at 20 mL/kg

    • Cardiac monit...

Follow-Up

Disposition

Admission Criteria

  • Hypotension or tachycardia unresponsive to IV fluids

  • Severe electrolyte imbalance

  • Children with >10% dehydration

  • Signs of sepsis/toxicity (rare in isolated giard...

Pearls and Pitfalls

Diagnosis is the greatest challenge in this disease: 
  • Include giardiasis in the differential diagnosis of all patients with diarrhea:

    • Giardia occasionally reported in domestic water ...

Additional Reading

  • Escobedo  AA, Almirall  P, Alfonso  M, et al. Treatment of intestinal protozoan infections in children. Arch Dis Child.  2009;94:478–482.

  • Escobedo  AA, Alvarez  G, González  ME,...

Codes

ICD9

007.1 Giardiasis 

ICD10

A07.1 Giardiasis [lambliasis] 

SNOMED

  • 58265007 Giardiasis (disorder)

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